Contributing Factors to the Occurrence of Stroke in Sub Saharian Sickle Cell Homozygous Patients

Introduction: Stroke is a major complication of sickle cell disease, with a high morbidity and mortality rate. This study aimed to determine the contributing factors to the occurrence of stroke in homozygous sickle cell disease patients. This is a study in Senegal and is first sub-Saharian report on SCD.

Patients and Methods: We conducted a case-control study among 66 homozygous sickle cell patients, including 22 with and 44 without stroke. Stroke was diagnosed based on imaging (CT and/or MRI). Socio-demographic, clinicobiological, and evolutionary aspects were recorded for each patient.

Results: The median age was 23 years (18 - 37) with a sex ratio (M/F) was 1.45. The most common age group was between 15 and 20 years (41.25%). The main diagnostic circumstances were persistent headache (54.5%) and hemiplegia (50%). The majority of patients had suffered an ischaemic stroke (77.3%), with a predominance of sylvian location (79.15%). Contributing factors were several VOCs / year >3, high hemoglobin S, low baseline hemoglobin, hyperleukocytosis, high hematocrit, thrombocytosis, high LDH, and high unconjugated bilirubin.

Conclusion: Stroke is a frightening and common complication of sickle cell disease, the occurrence of which is favored by the clinical severity of sickle cell disease and biological complications. Preventing these factors would reduce the risk of stroke in these patients.